Predictive Clinical Features And Efficacy Of Preoperative Anti-Vegf Treatment On Visual Acuity In Patients With Proliferative Diabetic Retinopathy

Objective: To study the efficacy of anti-VEGF therapy for proliferative diabetic retinopathy and preoperatively identify patient characteristics and factors that may predict visual outcomes. Methods: Retrospective review of the electronic medical records of 216 consecutive vitrectomies in 154 patients with a minimum follow-up period of 6 months. Results: The mean change in vision was 0.68 +/- 0.82 LogMAR for all eyes. The mean improvement in vision was greater in the anti-VEGF group (0.77) than in the pars plana vitrectomy (PPV) group (0.48) (t = 2.443 p = 0.015). The results show that 141 eyes (65.3%) improved by at least 0.2 LogMAR, 46 (21.3%) changed by <0.2 LogMAR, and 29 (13.4%) worsened by at least 0.2 LogMAR. Univariate logistic regression showed that preoperative anti-VEGF therapy (OR = 2.148 p = 0.018), preoperative vision in the operated eye (OR = 2.367 p<0.001), tractional retinal detachment (OR = 0.480 p = 0.025), and the use of silicone oil tamponade (OR = 0.478 p = 0.020) were independent predictors of greater improvement in best corrected visual acuity (BCVA). Multivariate analysis showed that preoperative vision in the operated eye (OR = 2.852 p<0.001) and the use of silicone oil tamponade (OR = 0.331 p = 0.002) were independent predictors of improved BCVA. Preoperative anti-VEGF therapy (OR = 2.984 p = 0.002) and tractional retinal detachment (OR = 0.437 p = 0.020) were independent predictors of improved BCVA by 0.2 LogMAR. Conclusions Most diabetic patients showed improved visual acuity after vitrectomy within six months. Preoperative anti-VEGF therapy is highly likely to improve BCVA by 0.2 LogMAR, and preoperative LogMAR BCVA is the strongest predictor of postoperatively improved BCVA.